As a mutual company, Northwestern is owned by policyholders rather than shareholders. The company is considered one of the top three providers of long and short term disability benefits. Even Northwestern Mutual realizes the importance of short term disability insurance and long term disability insurance in case you suddenly lose the ability to perform your occupation: “Don’t let an unexpected injury or illness put your financial future in jeopardy. Disability income insurance from Northwestern Mutual can help you protect your most valuable asset – your ability to earn an income. At the same time, it can also help provide a fundamental layer of security for your financial future.”
That is why it is so discouraging and disappointing that Northwestern Mutual disability denials are so common. If your Northwestern Mutual short term disability insurance or long term disability insurance claims are denied, you can request a free consultation with a Northwestern Mutual Disability attorney at Ortiz Law Firm. We will evaluate your disability claim, offer legal advice for the appeal process, and advise you of the steps we can take to prepare a comprehensive appeal letter.
If your claim was denied, you should consider hiring an attorney to help you appeal the denial and obtain the disability benefits you deserve. Don’t let the insurer deny you the benefits you and your family deserve. Call us at (888) 321-8131 to see what we can do to help.
Reasons for Northwestern Mutual Disability Denials
A Northwestern Mutual disability claim is usually denied when the disability insurance claim examiner has placed too high a hurdle for the claimant’s ability to prove he or she is disabled.
Every Northwestern Mutual long term disability policy creates a contract. Thus, the claims process is governed by the language in that contract. Each disability policy includes a proof of loss provision, which places the burden of proving a disability on the claimant. To prove a disability claim, the claimant must submit sufficient medical evidence of his or her disability and proof of his or her job duties and responsibilities.
As part of the disability insurance claim process, Northwestern Mutual will often review a disability claimant’s social media accounts, looking for evidence that they can use to justify a claim denial. Northwestern Mutual may also have its internal doctors and outside medical consultants review the claimant’s entire file, including any medical evidence. Northwestern Mutual’s adjuster will look for sufficient proof of a disability in the medical records to approve a claim.
Unfortunately, most treating doctors do not take great notes each office visit, and most physicians do not expect their notes to be carefully scrutinized by an insurance company. Mr. Ortiz has reviewed all too many disability insurance claims where the claimant is clearly disabled, but the medical records do not do a very good job of telling the whole story, so the insurer decides to deny the claim.
This benefits Northwestern Mutual, as the insurance company is only obligated to review the claim based on the medical records available and is not obligated to examine the claimant. If the insurance company does choose to examine the claimant, it is extremely unlikely that the claimant will receive a fair evaluation as the insurance company is paying the reviewing doctor.
One of the main things an attorney can help you with during the claim process is the dissection of the report from Northwestern Mutual’s hired doctors and responding with an argument and supporting medical records to explain to Northwestern Mutual why the claimant is, in fact, medically disabled under the terms of the disability insurance policy.
Northwestern Mutual Focuses on Insuring Professionals
Northwestern Mutual prefers to issue short term disability and long term disability insurance policies to doctors, lawyers, dentists, and other business professionals. While insurance companies like Northwestern Mutual have no problem collecting premiums on disability policies, they are not always so eager to pay out benefits for a legitimate claim, leaving disabled professionals without the benefits they were counting on. If the carrier continues to deny your appeal, we can file a lawsuit in federal court.
Disability attorney Nick A. Ortiz has experience in handling long term disability appeals with insurance companies. He has an extensive understanding of how insurance companies handle claims and the laws that may apply (such as ERISA law). Northwestern seems to be better at paying legitimate long term disability claims than most insurance companies, but even they have been known to issue an improper claim denial, and some claimants have even had to go to court to receive benefits.
Doctors, Lawyers, Dentists, and Other Professionals Must Be Able To Prove Their Pre-Disability Duties and Responsibilities
If you are a physician, lawyer, or other professional applying for Northwestern Mutual Disability benefits, then you must be aware that Northwestern is going to require you to submit very detailed information about the work you were performing before you filed your disability insurance benefits claim. For example, if you are a doctor, you will be asked for your monthly and annual CPT production reports for at least one year before the start date of your disability. You will also be asked to provide a monthly profit and loss statement, recent tax returns, and your daily appointment calendar.
If you are an attorney seeking disability, you may be asked for your appointment calendar for the past two years, your current case list with an itemization of each type of case, a description of your litigation-related work (if you are a litigator), recent tax returns, and monthly profit and loss statements for at least the past two years.
Oddly enough, if you have coverage for and are only seeking partial disability, Northwestern’s request for occupational information could be even more extensive. It is especially difficult to prove that you can perform your occupation on a part-time basis but you cannot return to work in your own occupation on a full-time basis.
Most professional claimants will also be asked to participate in an interview by a Northwestern Mutual insurance representative. Mr. Ortiz suggests that such interviews should never take place without legal representation. If Northwestern Mutual has asked you to participate in such an interview, you should request a free consultation with our firm to discuss the details of your disability claim with a professional.
Seek Help From an Experienced Northwestern Mutual Disability Insurance Attorney
Mr. Ortiz has seen claims be denied because the insurance company claims there is insufficient medical proof of the claim or because the insurance company is requesting information that cannot reasonably be produced. Mr. Ortiz takes great pride in assisting claimants in filing appeals for claims wrongfully denied or terminated (where benefits were initially approved but subsequently cut off). We also file lawsuits when the claimant has “exhausted” the appeals process with the insurance company.
When your claim for long term disability benefits has been wrongfully denied or terminated, it is important to find a lawyer with extensive experience handling LTD appeals and lawsuits. Nick A. Ortiz is the founder of the Ortiz Law Firm and an experienced disability lawyer. For years, Mr. Ortiz has championed disability claimants and takes great pride in helping disabled persons secure their long term disability insurance benefits.
As a long term disability lawyer, Mr. Ortiz approaches each case with intelligence and experience. He is familiar with the strategies and tactics insurance companies use to justify the denial of legitimate claims, and he can assist you in preparing a comprehensive appeal with evidence to dispute the denial.
Mr. Ortiz prefers to accept cases immediately after the initial denial letter by insurance companies like Northwestern. He and his staff help prepare and file the claimant’s internal appeal to maximize the chances that the LTD claim will be approved or reinstated. Where appropriate, Mr. Ortiz will file a lawsuit against the insurance company to either obtain a favorable settlement or prevail on the merits and have the claimant put back on claim.
We handle Long Term Disability claims on a contingency fee basis, meaning we only charge a percentage of the amount recovered. If there is no recovery, you owe us nothing. If your internal appeal is successful and we do not have to go to court, we charge a percentage of the back pay owed and a percentage of your future benefits for 12 months.
Request a Free Consultation For Your Northwestern Mutual Disability Claim
The Ortiz Law Firm has assisted numerous doctors, lawyers, and other business owners nationwide with their wrongfully denied Northwestern Mutual long term disability claims. Call us at (888) 321-8131 to discuss how we may be able to assist you in recovering the disability benefits you need to support your family and protect your way of life.